RN – Case Manager​/Utilization Review

Immediate need for a talented RN – Case Manager/ Utilization Review
. This is a 03+ months contract opportunity with long-term potential and is located in Santa Clara, CA (Onsite). Please review the job description below and contact me ASAP if you are interested.

Pay Range: $75 - $90/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

• Schedule:
  
  8:00 AM – 4:30 PM
• 5 days/week including
• Perform daily pre-admission, admission, and concurrent utilization reviews
• Determine appropriate levels of care using clinical guidelines and policies
• Coordinate inpatient discharge planning and transitions of care
• Participate in multidisciplinary rounds with physicians and care teams
• Communicate discharge plans with patients, families, and external providers
• Arrange transfers, post-acute services, and obtain authorizations as needed
• Ensure continuity of care through accurate documentation and follow-up
• Maintain compliance with federal, state, and institutional regulations
• Educate care teams on utilization and care coordination processes

• Acute hospital experience (inpatient setting)
• Knowledge of CMS, DMHC, NCQA, TJC, HIPAA, EMTALA
• Strong interdisciplinary communication and care coordination
• Ability to independently manage inpatient caseloads
• Healthcare benefit interpretation and authorization coordination
• Graduate of an accredited school of nursing
• Diploma or Associate Degree in Nursing (ADN) required
• BLS Certification (Required)
• Minimum 2 years of experience in:
• Case Management
• Recent acute inpatient hospital experience
• Ability to work rotating schedules and every other weekend
• Comfortable working in a Labor/Management Partnership environment
• Bachelor’s degree in Nursing or healthcare-related field
• Master’s degree in Case Management

Our client is a leading Healthcare Industry
, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.